Journal of Pediatric Neuroradiology 2014; 03(04): 155-160
DOI: 10.3233/PNR-14190
Georg Thieme Verlag KG Stuttgart – New York

Preterm cerebral microcirculation assessed with color Doppler: A pilot study

M.M.A. Raets
a   Department of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
,
P. Govaert
a   Department of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
b   Department of Pediatrics, Koningin Paola Children's Hospital, Antwerp, Belgium
,
T.G. Goos
a   Department of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
c   Department of Biomedical Engineering, Delft University of Technology, Delft, The Netherlands
,
I.K.M. Reiss
a   Department of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
,
R.C.J. de Jonge
a   Department of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
,
J. Dudink
a   Department of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
d   Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
› Author Affiliations

Subject Editor:
Further Information

Publication History

03 March 2014

16 May 2014

Publication Date:
29 July 2015 (online)

Abstract

AIM: Pilot study to explore feasibility of a color Doppler technique for monitoring cerebral perfusion at the level of microvessels.

METHODS: Between March 1st, 2011, and January 30th, 2013, all admitted infants born before 29 weeks of gestation were eligible for Doppler imaging. Perfusion images were acquired in a standard coronal plane. Image quality was assessed by two authors (MR, PG). The region of interest (ROI) was manually selected. A segmentation tool was developed to separate color data from the greyscale 2D images, leading to a percentage and number of color pixels in the image (Doppler color index; DCI). Intra- and inter-observer agreement was analyzed.

RESULTS: Intra- and inter-observer agreement for placement of ROIs was good (bias −0.24 resp. −0.74 percentage points). Color Doppler was able to depict microvessels in cortex, white matter and deep grey matter. The median DCI in a region of cortex-white matter was 7.8% with a wide range (1.4%–25.6%). There was no significant difference between the left and right hemisphere (Mann-Whitney U, P-value 0.61). Clinically relevant observations were tabulated, e.g. distant effect of germinal matrix hemorrhage (GMH) on regional perfusion.

CONCLUSION: Sonographic small vessel visualisation may help understand pathogenetic mechanisms related to perfusion and is valuable to monitor effects of treatment.